How Pharmacy First is changing local healthcare

When a common illness appears, getting the right advice matters more than guessing whether you need an antibiotic or waiting for an appointment you may not need. In England, NHS Pharmacy First lets participating community pharmacies assess certain conditions under agreed clinical pathways. A pharmacist can advise on self-care, recommend an appropriate treatment or, if the pathway allows it, supply a prescription-only medicine without a GP appointment. A consultation does not automatically mean you will be given medicine.

Which conditions are included?

The seven pathways cover sinusitis, sore throat, earache, infected insect bites, impetigo, shingles and uncomplicated urinary tract infections (UTIs). Each pathway has its own age and clinical criteria. For example, the UTI pathway is for women aged 16 to 64, while earache has a separate age range for children. If you are outside a pathway's criteria, a pharmacist can still advise you about what to do next, even if Pharmacy First treatment is not suitable.

What happens during a consultation?

The pharmacist will ask when your symptoms started, how they have changed, and about any medicines, allergies or relevant health conditions. They may examine the affected area where appropriate. Tell them if you are pregnant, have a weakened immune system, have tried treatment already or feel unusually unwell. These details help them decide whether self-care, treatment or a different service is the safest option.

You can ask to talk in a private consultation room. The pharmacist will explain their recommendation and when you should seek further help if symptoms do not improve. If the condition does not fit a pathway or there are warning signs, they may refer you to your GP, another NHS service or urgent care instead of supplying medicine.

Will I need antibiotics?

Not always. Many sore throats and sinus symptoms get better without antibiotics. The pharmacist uses the relevant clinical guidance to decide whether treatment is likely to help and whether it is safe for you. If medicine is supplied through the NHS service, usual NHS prescription charges or exemptions may apply. Ask the team if you are unsure about eligibility or charges.

When should I seek urgent help?

Do not wait for a routine pharmacy consultation if you have trouble breathing, severe difficulty swallowing, confusion, or signs of a serious allergic reaction. Call 999 for life-threatening symptoms. For other symptoms that are worsening quickly, or if you are unsure how urgently you need help, contact NHS 111. Babies, people who are frail or immunosuppressed, and anyone with symptoms that do not match a straightforward minor illness may need a different assessment.

Getting ready to speak to a pharmacist

• Make a note of when symptoms began and whether they are getting better or worse.
• Bring details of regular medicines, allergies and any treatment you have already tried.
• Explain any recent travel, pregnancy or long-term conditions that might affect treatment.
• Ask what to do if symptoms persist, return or become more severe.

If you think one of the seven conditions applies to you, ask our team about a Pharmacy First assessment. They can explain whether the service fits your circumstances and help you find the right next step if it does not.